PRE-PREDICTOR UPDATED EXAM
2026/2027 COMPLETE MULTIPLE
CHOICE QUESTION BANK WITH
VERIFIED ANSWERS DETAILED
EXPLANATIONS ALREADY GRADED A+
AND 100% PASS GUARANTEE
(ORIGINAL COPY!!!!!!!)
A 63-year-old male retired accountant complains of pain and
stiffness in his feet and hands of several years duration. He
reports that the pain and stiffness become worse with activity.
On examination, he is noted to have Heberden's nodes but no
other bony deformities. Which of the following is the most
probable diagnosis? - THE CORRECT ANSWER-Osteoarthritis (OA)
Although his vocation involved sedentary activity, this patient is
not at great risk for osteoarthritis. Rheumatoid arthritis is
characterized by several joint deformities, usually bilaterally
symmetrical. RA is characterized by inflammatory processes,
while OA is not. RA and OA are chronic conditions. Gout is
characterized by acute exacerbations related to a defect in
purine metabolism, increased uric acid production, or
decreased uric acid excretion.
The family of a 78-year-old man moved him into an assisted
living center because he can no longer be left at home alone. He
is unable to toilet when asked to do so and he has had several
episodes of incontinence. He has walked out of the facility twice
,and been unable to find his way back from 3 blocks away. On
examination, he is pleasant but mildly confused. Which of his
medications is LEAST likely contributing to his behavior? - THE
CORRECT ANSWER-ramipril (Altace®)
Tricyclic antidepressants, like amitriptyline, have
anticholinergic side effects which are especially problematic in
the elderly because they contribute to urinary retention.
Hydrochlorothiazide is a diuretic and may contribute to his
incontinence. Cimetidine is well known to produce adverse
reactions such as confusion in elders. Ramipril, an ACE
inhibitor, is unlikely to contribute to this patient's incontinence
or confusion. Toileting may be a complicated by the
anticholinergic medication and/or the diuretic causing diuresis,
urge incontinence, and inability to void at will.
A patient with no significant medical history has varicose veins.
She complains of "aching legs". The intervention that will
provide the greatest relief for her complaint is to: - THE CORRECT
ANSWER-elevate her legs periodically.
The intervention that will provide the greatest relief for this
patient is elevating her legs periodically. This will facilitate
venous return. Use of support stockings will prolong the length
of time she is able to stand in place, but will not provide relief
after her legs begin aching. Support stockings should be applied
prior to getting out of bed.
Stress urinary incontinence is: - THE CORRECT ANSWER-may be
aggravated by caffeine or alcohol.
,Stress urinary incontinence is not expected as a result of the
normal aging process. The primary problem is sphincter
incompetence. The ingestion of caffeine or alcohol decreases
sphincter control. Anticholinergic and antidepressant
medications are causative factors related to overflow
incontinence. Detrusor muscle instability is the primary
underlying problem causing urge incontinence.
Which commonly used herbal remedy is NOT associated with
anxiety and/or depressive symptom relief? - THE CORRECT ANSWER-
Ginkgo biloba
Ginkgo biloba is a common herbal remedy associated with
enhancement of vascular and cerebral perfusion and memory.
The nurse practitioner should be aware when the patient is
taking any herbal supplement to avoid risk of drug interactions.
Upon ophthalmoscopic examination of a 78-year-old patient,
the nurse practitioner observes dark spots against a red retina.
What diagnosis is this finding most consistent with? - THE
CORRECT ANSWER-Cataract
A cataract opacity is seen as a dark disruption of the red reflex
on ophthalmoscopic exam.
A 72 year old female patient reports a 6 month history of
progressively more swollen and painful distal interphalangeal
(DIP) joints of one hand. There are no systemic symptoms but
the erythrocyte sedimentation rate (ESR), antinuclear antibody
(ANA), and rheumatoid factor (RF) are all minimally elevated.
, What is the most likely diagnosis? - THE CORRECT ANSWER-
Osteoarthritis
When osteoarthritis affects the hands, the distal
interphalangeal (DIP) joints are usually involved. Rheumatoid
arthritis is usually symmetrical, and the proximal
interphalangeal (PIP) joints are more often affected.
Inflammation often develops quickly, not gradually. This
patient is elderly; therefore, it is expected that the ESR, ANA,
and RF will be only somewhat elevated. Over-interpretation of
laboratory tests without evidence of systemic inflammation can
lead to misdiagnosis.
The nurse practitioner is evaluating a 35-year-old female nurse.
She has a history of hospitalization for hepatitis B infection 2
years ago. Her laboratory tests demonstrate positive HBsAg.
The nurse practitioner would most likely diagnose: - THE CORRECT
ANSWER-chronic hepatitis B infection.
Presence of hepatitis B surface antigen at this time indicates
chronic infection with hepatitis B. Lab studies indicating a
positive surface antigen on 2 separate occasions at least 6
months apart indicate chronic infection. Immunization
produces positive hepatitis B antibodies in most instances.
Hepatitis B surface antigen would not be present in a person
who has recovered from hepatitis B infection. This case would
not be an acute episode because of the history of hepatitis B
infection 2 years prior.
One exception to the recommendation to limit dietary fat intake
is: - THE CORRECT ANSWER-children under 2 years-of-age.
2026/2027 COMPLETE MULTIPLE
CHOICE QUESTION BANK WITH
VERIFIED ANSWERS DETAILED
EXPLANATIONS ALREADY GRADED A+
AND 100% PASS GUARANTEE
(ORIGINAL COPY!!!!!!!)
A 63-year-old male retired accountant complains of pain and
stiffness in his feet and hands of several years duration. He
reports that the pain and stiffness become worse with activity.
On examination, he is noted to have Heberden's nodes but no
other bony deformities. Which of the following is the most
probable diagnosis? - THE CORRECT ANSWER-Osteoarthritis (OA)
Although his vocation involved sedentary activity, this patient is
not at great risk for osteoarthritis. Rheumatoid arthritis is
characterized by several joint deformities, usually bilaterally
symmetrical. RA is characterized by inflammatory processes,
while OA is not. RA and OA are chronic conditions. Gout is
characterized by acute exacerbations related to a defect in
purine metabolism, increased uric acid production, or
decreased uric acid excretion.
The family of a 78-year-old man moved him into an assisted
living center because he can no longer be left at home alone. He
is unable to toilet when asked to do so and he has had several
episodes of incontinence. He has walked out of the facility twice
,and been unable to find his way back from 3 blocks away. On
examination, he is pleasant but mildly confused. Which of his
medications is LEAST likely contributing to his behavior? - THE
CORRECT ANSWER-ramipril (Altace®)
Tricyclic antidepressants, like amitriptyline, have
anticholinergic side effects which are especially problematic in
the elderly because they contribute to urinary retention.
Hydrochlorothiazide is a diuretic and may contribute to his
incontinence. Cimetidine is well known to produce adverse
reactions such as confusion in elders. Ramipril, an ACE
inhibitor, is unlikely to contribute to this patient's incontinence
or confusion. Toileting may be a complicated by the
anticholinergic medication and/or the diuretic causing diuresis,
urge incontinence, and inability to void at will.
A patient with no significant medical history has varicose veins.
She complains of "aching legs". The intervention that will
provide the greatest relief for her complaint is to: - THE CORRECT
ANSWER-elevate her legs periodically.
The intervention that will provide the greatest relief for this
patient is elevating her legs periodically. This will facilitate
venous return. Use of support stockings will prolong the length
of time she is able to stand in place, but will not provide relief
after her legs begin aching. Support stockings should be applied
prior to getting out of bed.
Stress urinary incontinence is: - THE CORRECT ANSWER-may be
aggravated by caffeine or alcohol.
,Stress urinary incontinence is not expected as a result of the
normal aging process. The primary problem is sphincter
incompetence. The ingestion of caffeine or alcohol decreases
sphincter control. Anticholinergic and antidepressant
medications are causative factors related to overflow
incontinence. Detrusor muscle instability is the primary
underlying problem causing urge incontinence.
Which commonly used herbal remedy is NOT associated with
anxiety and/or depressive symptom relief? - THE CORRECT ANSWER-
Ginkgo biloba
Ginkgo biloba is a common herbal remedy associated with
enhancement of vascular and cerebral perfusion and memory.
The nurse practitioner should be aware when the patient is
taking any herbal supplement to avoid risk of drug interactions.
Upon ophthalmoscopic examination of a 78-year-old patient,
the nurse practitioner observes dark spots against a red retina.
What diagnosis is this finding most consistent with? - THE
CORRECT ANSWER-Cataract
A cataract opacity is seen as a dark disruption of the red reflex
on ophthalmoscopic exam.
A 72 year old female patient reports a 6 month history of
progressively more swollen and painful distal interphalangeal
(DIP) joints of one hand. There are no systemic symptoms but
the erythrocyte sedimentation rate (ESR), antinuclear antibody
(ANA), and rheumatoid factor (RF) are all minimally elevated.
, What is the most likely diagnosis? - THE CORRECT ANSWER-
Osteoarthritis
When osteoarthritis affects the hands, the distal
interphalangeal (DIP) joints are usually involved. Rheumatoid
arthritis is usually symmetrical, and the proximal
interphalangeal (PIP) joints are more often affected.
Inflammation often develops quickly, not gradually. This
patient is elderly; therefore, it is expected that the ESR, ANA,
and RF will be only somewhat elevated. Over-interpretation of
laboratory tests without evidence of systemic inflammation can
lead to misdiagnosis.
The nurse practitioner is evaluating a 35-year-old female nurse.
She has a history of hospitalization for hepatitis B infection 2
years ago. Her laboratory tests demonstrate positive HBsAg.
The nurse practitioner would most likely diagnose: - THE CORRECT
ANSWER-chronic hepatitis B infection.
Presence of hepatitis B surface antigen at this time indicates
chronic infection with hepatitis B. Lab studies indicating a
positive surface antigen on 2 separate occasions at least 6
months apart indicate chronic infection. Immunization
produces positive hepatitis B antibodies in most instances.
Hepatitis B surface antigen would not be present in a person
who has recovered from hepatitis B infection. This case would
not be an acute episode because of the history of hepatitis B
infection 2 years prior.
One exception to the recommendation to limit dietary fat intake
is: - THE CORRECT ANSWER-children under 2 years-of-age.
